Cervical Cancer
Development of cervical cancer
Symptoms
Diagnosis
Risk factors
Treatment effects

Cervical cancer

Cancer of the cervix, a common kind of cancer in women, is a disease in which cancer cells are found in the tissues of the cervix. The cervix is the opening of the uterus (womb). The uterus is the hollow, pear-shaped organ where the baby develops. The cervix connects the uterus to the vagina (birth canal).

Cancer of the cervix usually grows slowly over a period of time. Before cancer cells are found on the cervix, the tissue of the cervix go through changes in which cells that are not normal begin to appear (know as dysplasia). A Pap smear will usually find these cells. Later, cancer cell start to grow and spread more deeply into the cervix and to surrounding areas.

Development of cervical cancer

Cancer of the cervix can take many years to develop. Before it does, early changes take place on the cervix. Most women have heard of the Pap smear test. The smear test is designed to detect changes in the cells before they develop into a cancer, so that treatment can be given before a cancer develops. The aim of a smear test is to prevent cancer, but it can of course detect a cancer that has already developed.

The name given to the abnormal cells occurring in the cervix which are not cancerous but may lead to cancer is CIN (cervical intra-epithelial neoplasia). Some doctors call these changes precancer, meaning cells, which have the potential to develop into cancer if left untreated.

Symptoms

Precancerous changes of the cervix usually do not cause pain. In fact, they generally do not cause any symptoms and are not detected unless a woman has a pelvic exam and a Pap test. Symptoms usually do not appear until abnormal cervical cells become cancerous and invade nearby tissue. When this happen, the most common symptoms are: These symptoms may be caused by cancer or by other health problems. Only a doctor can tell for sure. It is important for a woman to see her doctor if she is having any of these symptoms.

Diagnosis

The pelvic exam and Pap smear test allow the doctor to detect abnormal changes in the cervix. If these exams show that an infection is present, the doctor treats the infection and then repeats the Pap test at a later time. If the exam or Pap test suggests something other than an infection, the doctor may repeat the Pap test and do other tests to find out what the problem is.

Colposcopy is the widely used method to check the cervix for abnormal areas. The doctor applies a vinegar-like solution to the cervix and then uses an instrument much like a microscope (called a colposcope) to look closely at the cervix. The doctor may then coat with an iodine solution (this procedure is called the Schiller test). Healthy cells turn brown; abnormal cells turn white or yellow. These are simple procedures can be done in doctor's office.

The doctor may remove a small amount of cervical tissue for examination by a pathologist. This procedure is called a biopsy.

The doctor also may want to check inside the opening of the cervix, an area that cannot be seen during colposcopy. In a procedure called endocervical curettage (ECC), the doctor uses a curette (a small, spoon-shaped instrument) to scrape tissue from inside the cervical opening.

These tests may not show for sure whether the abnormal cells are present only on the surface of the cervix. In that case, the doctor will then remove a larger, cone-shaped sample of tissue. This procedure, called conization or cone biopsy, allows the pathologist to see whether the abnormal cells have invaded tissue beneath the surface of the cervix. This procedure requires either local or general anesthesia and may be done in the doctor's office or in the hospital.

Risk factors

Strong risk factors for cervical cancer and its precursors have been identified to include:

At Slightly Higher Risk

Treatment effects

Surgery and radiotherapy for cancer of the cervix may have an effect on your sex life, but many of the changes can be either prevented or treated.

Radiotherapy to the pelvis can cause the vagina to become narrower and this can make sex difficult or uncomfortable. The key to overcoming this problem is to keep the muscles in the vagina as supple as possible.

If you have had a hysterectomy and your ovaries have also been removed, or if you have had radiotherapy to the pelvis, you will experience menopause symptoms (if you have not yet had menopause). These can include hot flushes, dry skin, dryness of the vagina, and possibly feeling low, anxious or less interested in sex for a time. Many of these symptoms can be eased by hormone creams or tablets, prescribed by your doctor, which replace the hormones that would have been produced by the ovaries.

Additional information about treatment of cervical cancer can be found on the Intervention and treatment page of Marleni Figueroa.

Also general information about cervical cancer on Understanding Cancer of the Cervix page.
 

References

1. Brinton LA: Epidemiology of cervical cancer overview. IARC Scientific Publications 119: 3-23, 1992.

2. Jones CJ, Brinton LA, Hamman RF: Risk factor of cervical cancer: results from a case-control study. Cancer Research 50(12): 3657-3662, 1990.

3. National Cancer Institute (NCI): What you need to know about cancer of the cervix, Booklet 1-19, 1994.

 


This web page was developed by Evelyn B. Cairo to fulfill a requirement of the class CHI 21: Health Issues in the Chicano/Latino Community taught by Seline Szkupinski Quiroga in the Chicana & Chicano Studies Program at the University of California at Davis, Fall 1998.